Renal biopsy with forceps through the femoral vein

To evaluate the usefulness of a new technique of transvascular renal biopsy with a flexible forceps in high-risk patients and compare its results with those reported for other techniques of renal biopsy.

Sixteen transfemoral renal biopsies were performed in 13 high-risk patients. Indications included severe bleeding disorders, combined renal-hepatic biopsy, morbid obesity, solitary kidney, and poor clinical condition. The technique was performed through the femoral vein; a 7-F Mullins introducer sheath was placed in a subcortical renal vein, and the biopsy was performed with a flexible biopsy forceps.

Renal tissue was obtained in 15 of 16 procedures (93.7%) with at least one glomerulus in 14 of 16 (87.5%), and at least six glomeruli in 11 of 16 procedures (69%). Samples adequate for diagnosis were obtained in 13 of 16 procedures (81%). Mean number of glomeruli per procedure was 12.6 (range, 0-39). Aside from transient hematuria in two patients, no other complications were known to have occurred.

Transfemoral renal biopsy is a safe technique for acquisition of renal samples in high-risk patients. The procedure can be performed at the same time as other vascular techniques. The histopathologic results, although worse than those obtained with the percutaneous approach, are better than those reported with other transvascular techniques.